Hope and Depression: Incorporating Hope into Treatment

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Hope and Depression Incorporating Hope into
Treatment

• Jennifer S. Cheavens
• The Ohio State University
• Laura E. Dreer
• University of Alabama at Birmingham

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Acknowledgements

• Low-Vision Study National Eye Institute,
  EyeSight Foundation of Alabama, UAB Clinical
  Research Unit and Department of Ophthalmology
• Hope Treatment Study University of Kansas,
  Department of Psychology

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Hope and Depression, Theoretical Relationships
Adapted from Cheavens, J. (2000). Hope and
depression Light through the shadows. In C. R.
Snyder (Ed.), Handbook of Hope Theory, Measures,
and Applications (pp. 321 340).
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Hope and Depression, Evidence
Hope and depressive symptoms strongly (inversely)
correlated in samples of

• Burn patients6
• Children with chronic illnesses7
• Post-stroke patients8
• Traumatically-acquired spinal cord injury9

• Adults1
• College students2
• Older Adults3,4
• Adults seeking psychological treatment1
• Cancer patients5

1. Cheavens et al., 2006 2. Kwon, 2000
3.Moraitou, Kolovou, Papsozomenou, Paschoula
(2006) 4. Kahle Snyder (2005) 5. Stanton,
Danoff-Burg, Cameron, Bishop, Collins, Kirk,
Swororski, Twillman (2000) 6. Barnum, Snyder,
Rapoff, Mani, Thompson (1998) 7. Venning,
Eliott, Whitford, Honnor (2007) 8. Gum, Snyder,
Duncan (2006) 9. Elliott, Witty, Herrick,
Hoffman (1991)
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Patients with Low-Vision and Their Caregivers An
Exemplar

• Vision loss represents a goal blockage for many
  patients and their caregivers
• Iterative and interactive process of adjustment
  between patient and caregiver
• Potential role of caregiver hope in the
  experience of depressive symptoms of both the
  caregiver and the patient

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Characteristics of the Sample

• Patients
• Age M 74 years (SD 13.6)
• Gender 64 female
• Race 88 Caucasian, 11 African American, 1
  Asian
• Vision Diagnoses Age-related macular
  degeneration (60), diabetic retinopathy,
  glaucoma, and other vision impairments
• Caregivers
• Age M 59 years (SD 13.62)
• Gender 67 female
• Race 89 Caucasian, 9 African American, 2
  Asian
• Caregiver Relationship to Patient Spouse (36),
  Daughter/Daughter-in-Law (34), Son (10),
  Sibling (7), Mother (4), Friend (3), Other
  (6)

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Procedures

• A research assistant read aloud all self-report
  measures to patients following their initial low
  vision eye examination.
• Family caregivers independently completed all
  demographic information and self-report measures.

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Results Hope and Depression

• Caregiver hope related to
• Depressive symptoms (r -.59, p lt.001)
• Satisfaction with life (r .58, p lt .001)
• Subjective burden (r -.21, p lt .05)
• Patient depressive symptoms (r -.22, p .03)
• Caregiver hope was not related to patients level
  of impairment

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Hope accounts for unique variance in the
prediction of depressive symptoms
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Results Hope and Depression

Caregiver Hope Score
R2 .12, p lt .01
R2 .34, p lt .001
Patient CESD Score Patient LogMar Score
R2 .15, p lt .01
Caregiver CESD Score
n.s. with hope in model
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Summary Low Vision Study

• Hope may be protective for caregivers
• Pathways related to perceived burden of
  caregivers
• Agency related to patients depressive symptoms
• Potential for intervention with caregivers

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Developing a Hopeful Intervention

• Two problems with a solely pathology focus
• 1. Many people who present for treatment are not
  mentally ill
• 2. Focus primarily on deficits may result in
  missed opportunities for change other than
  symptom reduction
• Incorporate lessons learned from research on high
  hope people

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Hope Intervention Study - Protocol

• Closed group format two hours per week for
  eight weeks
• 40 minutes review of homework from previous week
• 25 minutes psycho-education
• 30 minutes discussion of new material with focus
  on individualized application to goal
• 10 minutes homework commitment

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Hope Group Sample

• 39 participants recruited from the community
  newspaper story, flyers
• 32 completers with no significant differences on
  demographic variables or pre-treatment variables
  between completers and non-completers
• Completers 75 of intervention (N 15) and 88
  of wait-list control (N 17)

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Hope Intervention Resulted in Reduced Depressive
Symptoms
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Results

• Using Hierarchical Linear Regression models for
  both depressive symptoms
• After entering pre-treatment depressive symptom
  scores in the first step..
• Both pre-treatment hope and hope change scores
  remained significant predictors in a second step
  and resulted in R2? .30

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Summary

• Promising first step in the development of a hope
  intervention
• Potential for application in samples such as the
  caregiver sample
• Need more research, bigger samples, stronger
  controls

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Thank You!